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目的 深入挖掘天津市慢性阻塞性肺疾病(COPD)患者超限住院费用的影响因素,为进一步有针对地控制医疗费用提供方法学上的借鉴.方法 收集天津市2009-2013年城镇职工基本医疗保险数据库中确诊为COPD的全部出院患者进行回顾性分析.采用多元线性逐步回归筛选住院费用的外部影响因素,应用关联规则数据挖掘方法中的Apriori算法挖掘与超限住院费用存在强关联规则的条件属性,揭示隐含的关联规则.结果 多元线性逐步回归分析显示,住院天数、医院级别、手术治疗和年龄对住院费用影响的差异均有统计学意义(P＜0.01).关联规则模型共挖掘出4条有意义的关联规则,监测到发生费用超限患者占总超限的39.20％.具有规则前项条件的患者发生费用超限概率分别为原来的11.20、11.00、8.78和8.22倍.结论 挖掘出的强关联规则可以作为识别超限费用发生的警示信息,提示医院应缩短平均住院日,做好分级诊疗工作,从而控制住院费用,切实减轻COPD参保人员的经济负担.“,”Objective To mine in-depth the influential factors for the excessive hospitalization expense in patients with chronic obstructive pulmonary disease (COPD) in Tianjin,and to provide the methodological reference for specifically controlling the health care costs in further.Methods A retrospective analysis of the total discharged patients with COPD was performed according to the urban employee basic medical insurance database in Tianjin from 2009 to 2013.The multiple linear stepwise regression analysis was utilized to screen the exterual influential factors of hospitalization expense.The Apriori Algorithm in the association rules data mining was used to explore the condition attributes which had strong associations with the excessive hospitalization expense,then to reveal the implicit association rules.Results The multiple linear stepwise regression analysis indicated that days of hospitalization,levels of hospitals,surgical treatments and age of patients with COPD could significantly influence the hospitalization expense (P＜0.01).The association rule model could mine four association rule model,and found 39.20％ of patients with the excessive hospitalization expense.The probabilities of the excessive hopspitalization expense with the antecedents in the 4 association rules were 11.20,11.00,8.78 and 8.22 times than before.Conclusion These strong association rules could be used to identify the warning information about the excessive hospitalization expense,suggesting that the hospitals should shorten the average days of hospitalization and perform the hierarchical diagnosis and treatments.Consequently,the hospitals could manage to control the hospitalization expense and reduce the economic burden of the insured patients with COPD.